Comparing Participation and Interim Effectiveness of Endoscopy and Biomarker-Based Screening for Gastric Cancer: A...

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Gastric cancer (GC) screening compliance remains a challenge.
• Five biomarkers (pepsinogen I, pepsinogen II, PG I/II ratio, H. pylori antibody, gastrin 17) were evaluated for secondary GC screening.
• A randomized trial compared traditional endoscopy with biomarker-based screening.

Purpose of the Study:

• To assess the participation and effectiveness of biomarker-based versus traditional endoscopic screening for gastric cancer.
• To identify high-risk individuals for endoscopic screening more efficiently.
• To improve overall screening compliance and efficiency.

Main Methods:

• Randomized trial involving 74 communities assigned to traditional endoscopy arm (TEA) or biomarker-based endoscopy arm (BEA).
• BEA combined a questionnaire with biomarker detection (PG I, PG II, PG I/II ratio, HP-Ab, G17) for risk assessment.
• High-risk individuals in both arms underwent endoscopic screening; participation and interim effectiveness were analyzed.

Main Results:

• Biomarker-based endoscopy arm (BEA) showed a significantly lower high-risk rate (15.2%) than traditional endoscopy arm (TEA) (38.9%).
• BEA achieved a higher endoscopic participation rate for high-risk individuals (64.9% vs. 53.0%).
• No significant difference in GC abnormality detection rates or mortality between the two arms was observed.

Conclusions:

• Biomarker-based screening effectively identifies individuals at high risk for gastric cancer.
• This method significantly increases participation in endoscopic screening.
• Biomarker screening offers valuable insights for enhancing the efficiency of secondary GC screening procedures.